Introduction: With increasing organ shortage, transplant centers are increasing the utilization of DCD organs. However, the incidence of BKV has not been well investigated when comparing DCD vs. DBD. We hypothesized that DCD kidneys may be associated with an increased incidence of post-transplant BKV.
Methods: Seventy two (21.8%) patients receiving kidney transplants from DCD donors and 258 (78.2%) patients receiving allografts from DBD donors were compared between January 2008- September 2012. BKV was defined as any BK viremia or a BK viruria count above 100,000. All patients received Alemtuzumab induction and tacrolimus based steroid free immunosuppression. Overall graft survivals were compared using the Kaplan Meier curve log rank test. A Cox regression was used for multivariate analysis to determine predictive factors for graft loss.
Results: The basic demographics were comparable (recipient age, race, BMI, HLA mismatch and PRA) with the exception that patients using DCD were less extended criteria donors (ECD) (5.6% vs. 22.9%; p= 0.001). No differences were seen between the two groups in the incidence of ACR, CMV disease, new onset diabetes, 1 and 3 year GFR. There was a higher incidence of BKV in the DCD group compared to the DBD group (38.9% vs. 24.8%, P=0.018). DCD donors had worse 1 and 3 year actuarial graft survival (92% and 81% vs. 98% and 96% respectively P =0.019).
Predictors for graft loss were BKV (CI: 1.387-8.271; HR: 3.404) and DCD (CI: 0.121-.540; HR: 3.865).
Conclusion: Kidney transplantation using DCD was associated with an increased incidence of BKV. The higher incidence of graft loss in DCD recipients may perhaps be associated with the higher incidence of BKV.
To cite this abstract in AMA style:Lam H, Li S, Gunabushanam V, Tevar A, Tan H, Basu A, Sturdevant M, Humar A, McCauley J, Wu C, Shah N, Sood P, Randhawa P, Zeevis A, Lunz J, Shapiro R. Incidence of BKV after Kidney Transplantation with Tacrolimus (FK) Based Immunosuppression and Alemtuzumab Induction: A Retrospective Analysis of Donation after-Cardiac Death (DCD) vs. Donation after Brain Death (DBD) [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/incidence-of-bkv-after-kidney-transplantation-with-tacrolimus-fk-based-immunosuppression-and-alemtuzumab-induction-a-retrospective-analysis-of-donation-after-cardiac-death-dcd-vs-donation-after/. Accessed February 27, 2021.
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